Stool Short-Chain Fatty Acids in Critically Ill Patients with Sepsis.

Objective: To determine the concentration of stool short-chain fatty acids (SCFAs) in critically ill patients with sepsis and to compare the results between the critically ill patient and the control group.Methods: This descriptive, multicenter, observational study was conducted in five health institutions. Over a 6-month study period, critically ill patients with sepsis who were admitted to the intensive care unit (ICU) and met the inclusion criteria were enrolled, and a control, paired by age and sex, was recruited for each patient. A spontaneous stool sample was collected from each participant and a gas chromatograph coupled to a mass spectrometer (Agilent 7890/MSD 5975 C) was used to measure the concentrations SCFAs.Results: The final sample included 44 patients and 45 controls. There were no differences in the age and sex distributions between the groups (p > 0.05). According to body mass index (BMI), undernutrition was more prevalent among critically ill patients, and BMI in control subjects was most frequently classified as overweight (p = 0.024). Propionic acid, acetic acid, butyric acid, and isobutyric acid concentrations were significantly lower in the critically ill patient group than in the control group (p = 0.000). No association with outcome variables (complications, ICU stay, and discharge condition) was found in the patients, and patients diagnosed with infection on ICU admission showed significant decreases in butyric and isobutyric acid concentrations with respect to other diagnostic criteria (p < 0.05).Conclusions: The results confirm significantly lower concentrations of stool SCFAs in critically ill patients with sepsis than in control subjects. Due to its role in intestinal integrity, barrier function, and anti-inflammatory effect, maintaining the concentration of SCFAs may be important in the ICU care protocols of the critical patient.

Gut microbiota profiles in critically ill patients, potential biomarkers and risk variables for sepsis.

Critically ill patients are physiologically unstable and recent studies indicate that the intestinal microbiota could be involved in the health decline of such patients during ICU stays. This study aims to assess the intestinal microbiota in critically ill patients with and without sepsis and to determine its impact on outcome variables, such as medical complications, ICU stay time, and mortality. A multi-center study was conducted with a total of 250 peri-rectal swabs obtained from 155 patients upon admission and during ICU stays. Intestinal microbiota was assessed by sequencing the V3-V4 hypervariable regions of the 16S rRNA gene. Linear mixed models were used to integrate microbiota data with more than 40 clinical and demographic variables to detect covariates and minimize the effect of confounding factors. We found that the microbiota of ICU patients with sepsis has an increased abundance of microbes tightly associated with inflammation, such as Parabacteroides, Fusobacterium and Bilophila species. Female sex and aging would represent an increased risk for sepsis possibly because of some of their microbiota features. We also evidenced a remarkable loss of microbial diversity, during the ICU stay. Concomitantly, we detected that the abundance of pathogenic species, such as Enterococcus spp., was differentially increased in sepsis patients who died, indicating these species as potential biomarkers for monitoring during ICU stay. We concluded that particular intestinal microbiota signatures could predict sepsis development in ICU patients. We propose potential biomarkers for evaluation in the clinical management of ICU patients.

Ingesta de alimentos y su relación con factores socioeconómicos en un grupo de adultos mayores / Food intake and its relation with socioeconomic factors in an older adults group

RESUMEN Objetivo Describir la ingesta de alimentos y establecer la relación con algunos factores socioeconómicos en un grupo de adultos mayores. Materiales y Métodos Estudio descriptivo, transversal, con 178 adultos ≥60 años que asistieron a consulta odontológica en la Universidad de Antioquia entre septiembre de 2014 y febrero de 2015. Se midieron variables sociodemográficos, frecuencia de consumo de alimentos y escala de seguridad alimentaria. Para la asociación entre la ingesta de alimentos con variables socioeconómicas se utilizó la prueba Chi2. Para determinar los patrones alimentarios se utilizó el análisis de componentes principales para datos categóricos. Resultados Cerca del 50 % consumieron diariamente entre uno y tres veces lácteos y de uno a dos veces carnes, frutas y verduras. El 74,7 % consumieron cereales, plátanos y tubérculos más de cuatro veces al día, contrario a los granos secos y grasa monoinsaturada donde la frecuencia fue menor a una vez por día. La ingesta de lácteos y frutas tuvo una asociación significativa (p<0.05) con las variables: ingreso económico, estrato y seguridad alimentaria. Se identificaron tres patrones alimentarios denominados "dieta variada tradicional", "poco variada" y "alimentación fuera de casa" que explicaron el fenómeno en un 12,8 %, 9,9 % y un 8,4 % respectivamente. Conclusión El consumo diario de los grupos de alimentos en los adultos mayores, podría estar determinado por la condición socioeconómica, siendo mejor en aquellos de estrato medio, hogares seguros y con ingreso económico. El patrón que explicó la variabilidad del consumo en mayor proporción fue la dieta variada tradicional.(AU)

ABSTRACT Objective To describe food intake and establish the correlation between some socioeconomic factors in a group of senior adults. Materials and Methods Descriptive, cross-sectional study with 178 adults, ≥60 years old, who attended a dental consultation at Universidad de Antioquia between September 2014 and February 2015. Measurements for socio-demographic variables, frequency of food intake and food safety scale were obtained. The Chi-squared test was used to determine the association between food intake and socioeconomic variables. The categorical principal components analysis was used to determine feeding patterns. Results About 50 % of the sample consumed dairy between one and three times a day, and meat, fruits and vegetables from one to two times. 74.7 % consumed cereals, bananas and tubers more than four times a day, which contrasts with dry grains and monounsaturated fat, whose frequency was less than once per day. Dairy and fruit intake had a significant association (p<0.05) with the following variables: economic income, stratum and food safety. Three dietary patterns known as "traditional varied diet", "unvaried" and "eating out of home" were identified, which explained the phenomenon in 12.8 %, 9.9 % and 8.4 %, respectively. Conclusion The daily consumption of food groups in the elderly could be determined by the socioeconomic condition, being better in the medium stratum, who live in safe households and receive incomes. The pattern that explained the variability of consumption in greater proportion was the traditional varied diet.(AU)

[Food intake and its relation with socioeconomic factors in an older adults group]. / Ingesta de alimentos y su relación con factores socioeconómicos en un grupo de adultos mayores.

OBJECTIVE: To describe food intake and establish the correlation between some socioeconomic factors in a group of senior adults. MATERIALS AND METHODS: Descriptive, cross-sectional study with 178 adults, ≥60 years old, who attended a dental consultation at Universidad de Antioquia between September 2014 and February 2015. Measurements for socio-demographic variables, frequency of food intake and food safety scale were obtained. The Chi-squared test was used to determine the association between food intake and socioeconomic variables. The categorical principal components analysis was used to determine feeding patterns. RESULTS: About 50 % of the sample consumed dairy between one and three times a day, and meat, fruits and vegetables from one to two times. 74.7 % consumed cereals, bananas and tubers more than four times a day, which contrasts with dry grains and monounsaturated fat, whose frequency was less than once per day. Dairy and fruit intake had a significant association (p<0.05) with the following variables: economic income, stratum and food safety. Three dietary patterns known as "traditional varied diet", "unvaried" and "eating out of home" were identified, which explained the phenomenon in 12.8 %, 9.9 % and 8.4 %, respectively. CONCLUSION: The daily consumption of food groups in the elderly could be determined by the socioeconomic condition, being better in the medium stratum, who live in safe households and receive incomes. The pattern that explained the variability of consumption in greater proportion was the traditional varied diet.

OBJETIVO: Describir la ingesta de alimentos y establecer la relación con algunos factores socioeconómicos en un grupo de adultos mayores. MATERIALES Y MÉTODOS: Estudio descriptivo, transversal, con 178 adultos ≥60 años que asistieron a consulta odontológica en la Universidad de Antioquia entre septiembre de 2014 y febrero de 2015. Se midieron variables sociodemográficos, frecuencia de consumo de alimentos y escala de seguridad alimentaria. Para la asociación entre la ingesta de alimentos con variables socioeconómicas se utilizó la prueba Chi2. Para determinar los patrones alimentarios se utilizó el análisis de componentes principales para datos categóricos. RESULTADOS: Cerca del 50 % consumieron diariamente entre uno y tres veces lácteos y de uno a dos veces carnes, frutas y verduras. El 74,7 % consumieron cereales, plátanos y tubérculos más de cuatro veces al día, contrario a los granos secos y grasa monoinsaturada donde la frecuencia fue menor a una vez por día. La ingesta de lácteos y frutas tuvo una asociación significativa (p<0.05) con las variables: ingreso económico, estrato y seguridad alimentaria. Se identificaron tres patrones alimentarios denominados "dieta variada tradicional", "poco variada" y "alimentación fuera de casa" que explicaron el fenómeno en un 12,8 %, 9,9 % y un 8,4 % respectivamente. CONCLUSIÓN: El consumo diario de los grupos de alimentos en los adultos mayores, podría estar determinado por la condición socioeconómica, siendo mejor en aquellos de estrato medio, hogares seguros y con ingreso económico. El patrón que explicó la variabilidad del consumo en mayor proporción fue la dieta variada tradicional.

Microbiota intestinal y ácidos grasos de cadena corta en pacientes críticos / Gut Microbiota and Short-Chain Fatty Acids in Critically Ill Patients

Resumen Antecedentes: diversos estudios han mostrado cambios en la microbiota intestinal (MI) y los ácidos grasos de cadena corta (AGCC) en pacientes críticos con síndrome de respuesta inflamatoria sistémica (SRIS). Objetivo: revisar la evidencia sobre el papel de la MI y los AGCC en pacientes críticos y su modulación con prebióticos, probióticos y simbióticos. Materiales y métodos: búsqueda de artículos en bases de datos bibliográficas Pubmed, Science Direct, Ovid, Medline y Scopus, utilizando como descriptores microbiota, paciente crítico, unidad de cuidados intensivos, síndrome de respuesta inflamatoria sistémica, ácidos grasos de cadena corta, probióticos, prebióticos y simbióticos. Resultados: la MI en pacientes críticos está disminuida tanto en número de bacterias como en diversidad, lo cual puede resultar en una desregulación de la respuesta inmune sistémica ante la invasión de microorganismos patógenos. Los cambios en los AGCC en pacientes críticos se atribuyen a una disminución de bacterias anaerobias obligadas y sustratos de fermentación necesarios para su producción. La modulación de la MI con probióticos, prebióticos y simbióticos sugiere mejoría en la función intestinal. Conclusiones: la MI y los AGCC en pacientes críticos se encuentran alterados, de ahí que mantener el equilibrio en el entorno intestinal probablemente desempeñe una función clave para disminuir complicaciones y mejorar su pronóstico.

Abstract Background: Different studies have shown changes in gut microbiota and short-chain fatty acids in critically ill patients with Systemic Inflammatory Response Syndrome (SIRS). Aim: To review the evidence about the role of gut microbiota and SCFAs in critically patients and its modulation with prebiotics, probiotics and symbiotic. Materials and Methods: A search of the literature in Pubmed, Science Direct, Ovid, Medline and Scopus databases was conducted. The terms used were microbiota, critically ill, intensive care unit, systemic inflammatory response syndrome, short-chain fatty acids, prebiotics, probiotics and symbiotic. Results: The intestinal microbiota in critically ill patients is reduced in number and diversity, which can lead to dysregulation of the systemic immune response to the pathogenic invasion. Changes in SCFAs in critically ill patients are attributed to a decrease of obligate anaerobic bacteria and the fermentation substrates required for its production. The gut microbiota modulation with prebiotics, probiotics and symbiotic suggest improvement in bowel function. Conclusions: Gut microbiota and SCFAs are altered in critically ill patients; therefore, maintaining the intestinal environment is key for reducing complications and improving prognosis.